Moderating effects of attributions on the relationship between emotional dissonance and surface acting: a transactional approach to health care professionals' emotion work


  • Authors' note: This research received financial support from The Spanish Ministry of Science and Innovation (Program “José Castillejo” for the Mobility of Human Resources, JC2008-00085); The Institute of Health Carlos III-Subcommission for Assessment and Promotion of Research (National Plan of Scientific Research and Technologic Development and Innovation, PI070616); and The 8th Primary Healthcare Area of SERMAS (Madrid's Health Service).

Correspondence concerning this article should be addressed to David Martínez-Iñigo, Rey Juan Carlos University, Avda Atenas s/n Campus de Alcorcon, E 28922 Alcorcón, Madrid, Spain. E-mail:


Based on a transactional model of stress, this study aims to understand the role played by attributions in selecting surface acting as emotion regulation strategy when coping with emotion-rule dissonance. A sample of primary health care professionals (n = 87) based in Madrid filled in a questionnaire. Hierarchical multiple regression analyses were conducted to test hypotheses on the moderating effects of attributions on the relationship between emotion-rule dissonance and surface acting. Results showed that high levels of attribution to patients of responsibility for negative events, low levels of professionals' self-accountability, and low attribution of being able to promote a positive change strengthen the positive association between emotion-rule dissonance and surface acting. This could explain why professionals use a potentially damaging emotion regulation strategy.